Federal authorities are once again threatening to cut off funding for an embattled Uptown psychiatric hospital beset by complaints of physical and sexual abuse of young patients, including foster children in state care.

Chicago Lakeshore Hospital officials said Friday they are “working to come into compliance with regulations” before a Dec. 15 federal deadline. With more than 80 percent of its patients receiving Medicare or Medicaid benefits, hospital officials said the facility may shutter, reducing access to mental health services. Layoffs began within the last few days, officials said.

Also Friday, a federal judge tapped experts at a Chicago university to do an independent review of the safety of children at the hospital, and Illinois health officials said they may pull the psychiatric facility’s state license.

The Illinois Department of Children and Family Services stopped admitting children in its care to the hospital one month ago amid an increased number of hotline calls alleging harmful conditions. DCFS also began transferring foster children out of the hospital and stationing staff inside the facility 24 hours a day to better monitor its remaining patients.

Those steps were taken under pressure from child welfare watchdog groups and state lawmakers after separate reports about the hospital’s recent problems by the Chicago Tribune and ProPublica Illinois.

The final foster child left the hospital Friday afternoon, said DCFS spokesman Neil Skene. He said all are in foster homes or residential treatment facilities with support services. While transferring children, two 17-year-old boys ran away in separate incidents, but both have been located, Skene said.

The hospital pledged to work with state and federal agencies to fix the problems. It’s unclear, though, what inroads Chicago Lakeshore can make before a deadline that’s just two weeks away. After another threat a few months ago to cut off government funding, the hospital asked a federal judge to intervene, then withdrew its request when regulators agreed to give the hospital more time.

On Friday, Lakeshore officials would only say that “options are being explored.”

“Many of the children we serve have no place else to go, and we offer the best hope for their stabilization and return to society,” Dr. Peter Nierman, the hospital’s chief medical officer, said in a statement. “Frankly, this is a population that virtually no other facility wants to take, and I believe that without Lakeshore, the already tragic story of some of these children will only be further exacerbated.”

DCFS launched at least its 20th hotline investigation last week. The latest complaint accused hospital staff of inadequate supervision regarding sexual activity between teenage patients. It was the fourth hotline call in recent weeks, including a Nov. 19 complaint involving a 9-year-old patient who accused a staff member of choking her while trying to restrain the child.

The hospital had only about 17 total hotline investigations in the prior three years, according to DCFS statistics. Most of this year’s hotline investigations were sparked when hospital staff, who are required to report under state law, notified child welfare officials of the allegation.

The Illinois Department of Public Health, which licenses the hospital, had been inspecting Chicago Lakeshore in recent months mostly for regulatory safety issues, such as whether adequate suicide-prevention measures were in place regarding the length of telephone cords or the doors to empty rooms were properly secured. The state health department contracts with the federal government, which is in charge of Medicaid and Medicare funding.

On Friday, state public health spokeswoman Melaney Arnold said recent media reports led the agency to also investigate complaints alleging young patients were physically or sexually abused. Inspectors found the hospital staff failed to notify state health officials about the complaints as required, and that the facility often failed to take corrective action or launch sufficient investigations, according to the reports.

State health officials recommended termination of federal funding and are “looking at license suspension or revocation,” Arnold said.

On the federal front, the hospital was informed of the Dec. 15 deadline to cut off funding in a certified letter dated Thursday.

“We have determined that the deficiencies are so serious they constitute an immediate threat to patient health and safety,” wrote Nadine Renbarger, an associate regional administrator of the federal Centers for Medicare & Medicaid Services. “The deficiencies limit the capacity of your facility to render adequate care and ensure the health and safety of your patients.”

In recent weeks, DCFS repeatedly has been hauled into federal court as it battles with the American Civil Liberties Union of Illinois over concerns about the psychiatric facility. The ACLU, which monitors DCFS through a decades-old federal consent decree, called for an outside review of the hospital.

During a court hearing Friday, U.S. District Judge Jorge Alonso approved the University of Illinois at Chicago psychiatry department to oversee the review, which the hospital said it welcomed.

“Chicago Lakeshore Hospital knows improvements can be made and we will continue to steadfastly make those improvements, but shutting us down is tantamount to throwing out the baby with the bathwater,” hospital CEO David Fletcher-Janzen said in a statement.

Alonso also ruled that a retired federal judge will be appointed with decision-making authority to help DCFS and the ACLU iron out its frequent disputes in the consent decree case. DCFS unsuccessfully opposed the ACLU’s request for a so-called “special master,” instead favoring a facilitator without as much authority.

Chicago Lakeshore is one of the largest hospitals for psychiatric services in Illinois. An estimated one-quarter of DCFS kids who need inpatient psychiatric services are treated there, and many languish beyond their scheduled discharge date as the state agency struggles to find homes with appropriate services.

If the hospital closes, DCFS officials said the larger challenge is not just the dwindling number of psychiatric beds but the need for “a more robust mental health system to provide more treatment to more people in their own communities, without hospitalization.”

“The capacity of the mental health system is not just a DCFS challenge but a challenge for the state of Illinois,” DCFS Acting Director Beverly “B.J.” Walker said in a statement. “We need to put more attention on ways to reduce the need for psychiatric hospitalization.”